WHEN Keira Smith married her husband Shaun in 2013, she knew they were facing an uphill battle to have children naturally.
He was taking medication that affected his fertility, so in 2018 Keira was delighted to get pregnant via IVF.
However, 34 weeks later that joy turned to devastation when their baby Mali died three days after birth, due to medical negligence.
Keira, 39, is sharing her story after a damning report found half of NHS maternity units are unsafe.
The Care Quality Commission rated 48 of 131 services "inadequate" or "requires improvement", while a shocking 65 per cent did not meet "good" safety standards.
The report found that incidents are poorly managed and not learned from, not all patients receive a safe assessment, mums-to-be face long delays due to short-staffing, and there are also concerns about how maternity staff communicate and engage with women and their families.
NHS maternity services have come under increased scrutiny in recent years after a series of high-profile inquiries, including the Ockenden Review into more than 200 baby deaths at the Shrewsbury and Telford Hospital NHS Trust, as well as an investigation into services in East Kent.
Keira told The Sun: “I met Shaun in 2009, and we had a fabulous life together, going to festivals and travelling.
“Then in 2012, the year before we got married in Jamaica, he was diagnosed with psoriatic arthritis, a painful condition which causes red patches and sore joints.
“He took Methotrexate to combat it, but knowing it could affect his fertility, we had sperm samples taken.
“We did try to conceive naturally, and Shaun came off medication, but was in immense pain so we had IVF via the NHS, at the Welsh Institute of Fertility in Cardiff.
“It was about a year before I was at the point of having an embryo implanted, in spring 2018.
“When it was successful, we were over the moon and – this is something I beat myself about for ages afterwards – I told people that it all seemed quite easy.
“I wasn’t that sick, and didn’t even feel that tired.”
Because she was an IVF patient, Keira had regular check ups, and when she was just over 34 weeks, she saw a consultant.
The scanner was broken but he confirmed what her midwife had told her – that the baby was breech, meaning it was lying feet first.
After the appointment, she popped to the loo and there was a “show” – a sign she was in labour already.
Keira, who works in HR at Cardiff Metropolitan University, said: “The maternity unit confirmed I was in labour and transferred me to Bridgend Hospital, where my waters fully broke.
“The consultant there told me, ‘You need a C-section, but we don’t want to deliver too early, the longer she’s in there the better’.
“To begin with, I felt fine and there were no contractions.”
But the next day, Keira’s contractions began, although a consultant told her she wasn’t dilated.
I bathed her, brushed her hair, dressed her, and she passed away peacefully in my arms. Going home without her was the worst moment of my life
Keira Smith
“The pain was getting worse. I told the midwife, ‘I can feel my body pushing, I’ve got no control’,” she said.
“It all felt so alien to me as I’d never given birth before.
“I was alone with Shaun when suddenly I put my hands down and the baby’s feet were outside my body.
“It all kicked off: I was screaming, ‘The feet are out, the feet are out!’ and Shaun was in the corridor shouting, ‘She’s in labour, she’s been telling you and telling you but you haven’t listened’.”
The next two hours were a blur of panic as Keira was wheeled to a delivery suite and gave birth naturally.
“I was begging for a C-section but by then it was too late, there was no going back,” she said.
“Mali was born, silent: they spent 16 minutes resuscitating her, but she’d been without oxygen for at least that long, and probably longer.
“Then she was whisked away to the Special Care Baby Unit.”
Keira added: “One thing that sticks in my mind was midwives congratulating me on the birth.
“They kept saying she was doing well for a baby that had been without oxygen for so long.”
Baby Mali was transferred to a bigger hospital, the Royal Gwent in Newport.
For the first 24 hours, the couple had prepared themselves for the news that Mali might be disabled, but now medics told them the devastating truth: she was not showing any real signs of life.
“She was small at 4lbs 9oz but she was perfect: her heart, lungs, size,” Keira said.
“They told me if she’d been born by C-section she’d have had every chance.
“After three days, they gently told us we needed to think about withdrawing life support.
“I wasn’t really functioning, but I remember thinking I didn’t want to prolong the pain for her.
“We said our goodbyes. I bathed her, brushed her hair, dressed her, and she passed away peacefully in my arms.
“Going home without her was the worst moment of my life.
“The bottom had fallen out of my world, and I couldn’t believe other people were still going about their daily lives.
“It was surreal, it felt like madness.”
By Sam Blanchard, Health Correspondent
URGENT action is needed to fix NHS maternity services as half of them are below standard, inspectors warn.
An audit by the Care Quality Commission found massive variation in mum-and-baby units but also “common areas of concern” across England.
It rated 48 per cent of 131 inspections “inadequate” or “requires improvement”.
A shocking 65 per cent did not meet “good” safety standards.
Official figures show the number of women dying during pregnancy or shortly after the birth of their baby is at a 20-year high.
The CQC said many clinics do not properly report or learn from safety incidents.
Mums-to-be often face long delays due to short-staffing, it added, and their concerns are not always taken seriously.
Communication with families is not as good as it should be, either.
Nicola Wise, hospitals director at the CQC, said: “Although we’ve seen examples of good care and hardworking staff doing their best, we remain concerned that key issues continue to impact quality and safety.
“Disappointingly none of those issues are new.
“We cannot allow an acceptance of shortfalls that are not tolerated in other services.
“We must do more to ensure that poor care and preventable harm do not become normalised.”
The national review inspected all maternity services that had not been visited and rated since 2021.
It said some failings could be fixed within hospitals but others would need more cash and action from the Government.
The report said scandals at the East Kent hospitals and Shrewsbury and Telford were not isolated and families are being let down nationwide.
A review is already under way in Nottingham, which saw family outcry at a public meeting with the local hospital on Wednesday.
Health Secretary Wes Streeting said maternity care is “one of the biggest issues that keeps me awake at night worrying.”
He said: “We're keen to make sure that lessons are applied right across the country.
“We are determined to get this right.”
Shortly afterwards, as the couple registered both Mali’s birth and death, Keira received a call.
It was charity, set up by Rhian Mannings, offering her help and support.
“That call was everything I needed that I didn’t know I needed at the moment in time,” said Keira.
“They organised counselling and other therapies. I would have been lost without them.”
But grief was taking its toll on her marriage to Shaun.
While Keira cut herself off from the world, and stayed at home, taking time off, her husband coped by going back to work and continuing with normal life.
“I was in a big hole of grief and didn’t want to rejoin the world. He was as bereft as me in other ways,” she said.
“I would get comfort from going to her grave, in a local cemetery, but that would just floor him.”
When I first heard Macsen cry, it was like I’d taken a breath for the first time in 18 months
Keira Smith
The couple tried to heal their pain by having IVF again.
Keira said: “I knew I couldn’t replace Mali but I needed a child with me.
“I was convinced the IVF would fail, but I got pregnant straight away.
“The emotional strain and worry was horrendous.
“For me, nothing would feel right until I walked through the door of my home with my new baby.
“Shaun and I started to pull apart from each other – and then Covid hit, which made things worse.”
Happily, on May 18, 2020, Keira gave birth to a healthy 7lbs 5oz boy called Macsen, an ancient Welsh name.
But it was too late for the marriage, and the couple split two months later.
“When I first heard Macsen cry, it was like I’d taken a breath for the first time in 18 months,” she said.
“But as overjoyed as we were, the damage had been done to our marriage.
“Bereaved parents go one way or the other, and we weren’t going to survive that.”
Supported by friends and family in the town of Abertillery, Monmouthshire, Keira got back on her feet, and worked out a co-parenting routine with her ex, and they’ve raised Macsen side by side ever since.
But she was determined to give back to 2wish, the charity that helped her when she was so low.
Two years ago, she walked with a group of bereaved parents and supporters to the top of Kilimanjaro, raising £60,000, and now she is trekking to Everest Base Camp to raise more money.
“For me it’s another journey I can take with Mali,” she said.
“It’s about furthering her legacy and her memory: we’re trying to raise awareness and raise as much money as we can for an amazing charity.
“I live at the bottom of a mountain, so I’ve been training there, but I’m worried about the altitude too – you just don’t know how you’ll cope until you are there.”
Last year also saw the conclusion of the legal case Keira and Shaun made against the hospital.
It had already admitted negligence after an internal investigation, but Keira felt real change was needed.
“I wanted justice for Mali,” she said. “And they didn’t deny liability.
“I have a massive amount of respect for the NHS, but ultimately the system failed Mali, and we need to do as much as we can to make sure that no one else goes through what we went through.”
